A double-blind comparison of fluphenazine decanoate and flupenthixol decanoate in the treatment of acute schizophrenia.

A double-blind comparison of fluphenazine decanoate and flupenthixol decanoate in 40 consecutive admissions showed no difference in anti-psychotic effect or extrapyramidal side effects after 56 days. However, the trial identified a different effect of the drugs on mood. Flupenthixol decanoate had an elating effect that was most marked during the week following injection. Fluphenazine decanoate tended to lower mood. The results would suggest that in acute schizophrenia, fluphenazine decanoate would be the more appropriate drug in elated or acutely disturbed patients, but that in patients with a lowered mood or a history of depression, flupenthixol decanoate would be the more appropriate drug. It was emphasised that these mood changes were observed in patients with acute schizophrenia and that extrapolation from these results to maintenance therapy of chronic relapsing schizophrenia should only be made with caution. The results suggest that 40 mg of flupenthixol decanoate is approximately equal to 25 mg of fluphenazine decanoate. Analyses of covariance showed a significant positive correlation between the incidence of extrapyramidal side effects and duration of illness.